MMGMA 2007 Legislative Issues Recap

MMGMA's Government Affairs Committee, with the great help of the association's leadership and members, had an even greater presence at the Legislature and with state agencies in 2007 than in past years. We succeeded on some fronts and made progress on others, and believe we continue to make a real difference for patients and our practices.

Language Interpreter Reimbursement: We almost succeeded in getting legislation passed that would require health plans to reimburse providers for interpreter costs, effective July 1, 2008. We worked out a compromise with the health plans and had clear majorities in the House and Senate supporting our bill. The Governor, however, was opposed to this mandate and promised to veto any bill containing the requirement. Language did pass setting up an interim committee to study the issue and bring back recommendations for the 2008 session. There are indications that the Governor's office is willing to reconsider their position so long as there are safeguards against billing fraud. We will make this a major priority in 2008 and hope to get the requirement passed early in the session. Senator Linda Higgins and Representative Maria Ruud were our Chief Authors and demonstrated skill and tenacity in moving the legislation along.

Transparency Requirements: We succeeded in amending 62D.81, by making providers' obligations to provide consumers with cost information more reasonable and accurate. Now providers, or their designees, must provide consumers, upon their request, a good faith estimate of the allowable payment (sometimes referred to as the contracted rate) that the provider has agreed to accept from the consumer's health plan company for the services specified by the consumer. Language was added late in the process, without MMGMA's knowledge or support, prohibiting a provider or its designee from charging the consumer or the consumer's employer for the estimate.

In addition, where a consumer has no applicable coverage, the provider must give the consumer a good faith estimate of the average allowable reimbursement that the provider accepts from private third party payers for the services specified by the consumer, and the estimated amount the consumer would be required to pay.

Finally, the statute now requires health plan companies to provide enrollees or their designees, upon their request, with a good faith estimate of the allowable amount that the health plan company has contracted for with a specific network provider as total payment for a service. Health plan companies must also provide an enrollee with an estimate of the portion of the allowable amount that will be due from the enrollee and the enrollee's out-of-pocket costs. Representative Bunn was instrumental in getting our language into the Omnibus Health and Human Services bill.

HSA Direct Assignment and Collecting Estimated Payments From Patients With High Deductible Plans: We had legislation drafted and introduced in the House and Senate that would require direct payments by HSAs to providers for services rendered and permit providers to collect an estimated payment at the time of service from consumers with high deductible insurance plans. Because the bill was introduced later in the session we were not able to get a hearing scheduled but our authors will press for hearings early in the 2008 session. Health plans have acknowledged the problems but do not yet support our remedy.

MinnesotaCare/M.A. Fee Schedule: We made the MNCare/M.A. fee schedule a major educational and lobbying priority during the last session. Many legislators expressed surprise that the fee schedules had not been increased since 1999. Senator Linda Berglin, in a letter to our president, Barb Daiker, actually registered surprise that we had not received an increase, especially through PMAP, since the health plans have been getting increases for pre-paid managed care over the years. We are working at scheduling a meeting with her to discuss the issue and hopefully come up with a plan for future budgets.

Contingent Reduction in the Provider Tax: MMGMA strongly supported a bill introduced by Representative Ruud, which provided for a contingent reduction in the provider tax rate when surpluses are forecast. While this bill did not get heard this session, health and human services finance committees did largely avoid spending Health Care Access funds for items other than MinnesotaCare.

Tiering: MMGMA had a bill drafted and introduced in the House and Senate that would prohibit the Department of Employee Relations (DOER) from including external costs (such as hospital costs) when profiling medical practices and would require full disclosure of the cost components used in tiering group practices. This is especially important to members in greater Minnesota. Senator Dan Larson is taking a lead on this issue and plans to request a hearing early in the next session.

The MMGMA Government Affairs Committee was extremely active during the 2007 Session and networked with allies, as appropriate, such as the Minnesota Medical Association, the Minnesota Provider Coalition and the Minnesota Hospital Association. One hundred thirty seven members served as "key contacts" with one hundred nine legislators. At our 2007-Day at the Capital, sixty-seven meetings were held with legislators to discuss our session priorities. Letters sent through our "legislative action center" to urge action on our priorities, exceeded all previous efforts. MMGMA members interested in joining this effort can call Matt Schafer at 612-701-5637.   We greatly appreciate the input and feedback we received from our membership and look forward to engaging you again as we prepare for the 2008 Legislative Session.

Government Affairs Committee Leadership

Candy Simerson, Chair

Geoff Sylvester, Chair-elect

Lobbying Team
Doug Stang

Dave Kunz

Matt Schafer

Government Affairs Committee Advisor
Phil Riveness

Government Affairs Committee
Ann Peterson

Barb Daiker

Bill Evans

Bonnie Bina

Corinne Abdou

Dan Grosskopf

Dave Kunz

Dave Renner

Deneace Tucek

Doug Stang

Libby Lincoln

Franklin Iossi

Geoff Sylvester

Jack Davis

Jim Reimann

Jim Sieben

Jim Tierney

Jim Wilkus

Judy Hovell

Matt Schaefer

Mike Foley

Paul Louiselle

Paul Wilkus

Peter Bartling

Sara Freppert

Sue Schettle

Sue Wilkus

Victoria Champeau